Saturday, November 29, 2008

Breastfeeding, infant jaundice and Chinese herbs

I received an email from a concerned mother inquiring about the effects of Chinese herbs on breastfeeding mothers. Mary was particularly concerned if taking Chinese herbs for postnatal breastfeeding women could cause jaundice in babies.

Below is my reply to Mary:


Dear Mary,

Good day to you. It's always delightful to know more and more people are interested in traditional medicine. And that people realize again how important breastfeeding is.

An invalid idea: "Breastfeeding mothers taking Chinese herbs will cause babies to have jaundice" is an invalid statement or idea.

Physiological or pathological? First of all, many people are messed up with physiological jaundice and pathological jaundice. A physiological one is a normal one which usually begins from day 2 to day 3 and will disappear by itself in one or two weeks. As a matter of fact, physiological jaundice can take place anytime within one or two months. Some simple traditional remedies are sunbathing babies in the early morning, taking mild sugar solution, or phototherapy. A pathological one, of course, is more complicated and needs to deal with depending on the type of pathological changes: viral hepatitis, maternal-fetal blood type incompatibility, other infections or a thyroid problem.

The traditional explanations of having physiological jaundice are:

Possibility 1) Late bowel motion of newborns. For this type, early or more frequent feedings of breast milk to help infants pass the bilirubin in their stools may be recommended.

Possibility 2) Late or lack of breastfeeding by mothers. This jaundice occurs when the baby is not getting enough breast milk, either because of difficulty of breastfeeding or the mother's milk isn't enough yet. For this type, there's nothing wrong with the breast milk itself, it's simply because the baby has not enough to drink.

Possibility 3) Certain substances in milk. In 1% to 2% of babies, their jaundice could be caused by substances in the mother's breast milk. Some substances cause bilirubin to rise. This type usually begins from the first 3 to 5 days, and conditions improve over 1 to 3 months. If it's highly suspect case of such, and the bilirubin level rises toward the need of exchange transfusion, a mother can temporarily stop breastfeeding for 2 days, and resume after the jaundice subsides.

Boosting milk supply: There are certain Chinese herbs that boost a breastfeeding mother's supply of milk and thus allow young mothers who otherwise aren't able to breastfeed to do so. And if jaundice occurs after such cases should we blame it on late breastfeeding or consumption of Chinese herbs? Bear in mind that the newborn was late or not getting good supply of mother's milk at all initially. Could the physiological jaundice have taken place because of late or the lack of breastfeeding? Or the late bowel motion due to late or lack of breastfeeding (Breastfeeding helps first bowel motion)? Or more conveniently, some people will just blame it on the Chinese herbs.

Taking care of postnatal women: There are many postnatal illness or symptoms which have been treated with Chinese herbs. For these highly individual cases, the mother's body type or syndrome must be determined properly through face-to-face consultation before an appropriate therapeutic principle can be drawn on and thus the herbal formula prescribed. Herbs common for postnatal women usually possess the effects of nourishing yin fluid, promoting blood growth and circulation. They tend to strengthen the body constituent, encourage uterus contraction and prevent postnatal infections.

Traditional preparations: Some herbs do get into the breast milk, making milk yellowish in colour, and a few have milk withdrawal effects. Fortunately for us, or as in the wisdom of traditional Chinese medicine, these herbs aren't in the traditional preparation for wellbeings of postnatal women.

Traditional herbal formula for postnatal women's wellbeing are very safe. Many have been used for hundreds of years if not thousands. This is the reason these proven formulas are made into over-the-counters for the ease of availability. For treatments of more specific postnatal illnesses or symptoms, please consult TCM physicians for proper individual prescription.

I hope the info helps. And your effort in helping new moms to breastfeed and live a natural lifestyle is admirable. Keep it up please.

Do let me know if you have any other questions.

John Lew


Mary said...

Dr Lew,

Thank you for your prompt reply & your thorough explanation. Hope we will be able to read more about Chinese herbs & its usage from your informative blog.

Once again, thanks for replying to my mail.

Best regards,

raylis said...

Hi Dr. Lew,

I hope you receive this.

I'm nursing my 10mo baby, and have been prescribed the following for weak yin in kidneys:
1) Liu Wei Di Huang Wan
2) Tien Wang Pu Hsin Tan
3) Xiang Sha Yang Wei Wan

Are they safe for consumption, and will they affect my baby...?

Thank you kindly

John J. C. Lew said...

Dear Raylis,

Good day to you.

From your info you're currently taking the three OTC herbal formulae prescribed by a TCM practitioner, for the purpose of kidney yin deficiency, and currently you're breastfeeding your 10-month-old baby.

Many people ask the word "safe" on herbs they're taking. The answer depends on if the diagnosis is right and if the prescription is done according to the right theories.

For a "general" reply to your question, the three OTC formulae are rather safe: No 1 is for kidney yin; No 2 is for heart yin; No 3 is for stomach and spleen absorption function.

They should be ok for you and your baby. Bear in mind that it's always difficult to do online consultation because it doesn't involve face reading and pulse taking.

That's why I gave up the idea of online consultation long ago.

I can only share with you some general ideas about natural medicine, hardly anything specific or individually.

I'm sorry about the limitation and I wish you and your baby all the best!

John LEW

jennvaz said...

Dr Lew,

I am in my last month of pregnancy. I went to a medical hall two days ago and the sin seh recommended that I take 'da huang' now to prevent my baby from getting jaundice. I have taken two servings of it. However, while browsing through the net today, I learnt from some websites that 'da haung' is not suitable for pregnant ladies. Is it true? Is 'da huang' safe?


John J. C. Lew said...

Dear Jennifer,

Da Huang, or Rhubarb, is not strictly a forbidden herbs for pregnant ladies. 'Suitable' or not it depends on the stages of pregnancy or if that's a need. For early stage of pregnancy, Da huang should not be used for most purposes.

Da huang is strong in purging bowel motion. The one that has been treated with ethanol has less purging power and therefore it's better for invigorating blood for cases of blood stasis.

Da huang is used, among other purposes, for jaundice especially for the type of phlegm heat. I know some phsicians use it for pregnant ladies in late pregnancy to prevent infantile jaundice. I personally don't do that.

I hope your physician knows what he or she is doing for your goodness. And hopefully the dosage involved is of his or her good control and experience.

If you've had it for 2 times and things seem normal, it's then usually ok.

Good luck!

John Lew